Use this as the mainframe for the assignment. The Feasibility Study will focus on Termination Services in a Women’s Health Practice at new york presbyterian hospital. The paper is a rough proposal that was already submitted and must be elaborated on. Please see all instructions. The SWOT analysis was already submitted- it is attached and must be used as part of the paper. The SWOT is also a rough draft and should be used as a source and elaborated on. Daniels and Dickson (1990) article was also attached and is a requirement to use as a reference. PLEASE USE ALL ATTATCHMENTS. The HT5 Women’s Health Practice is a resident-based practice at the New York-Presbyterian/Weill Cornell teaching hospital, the top four hospitals in the nation. The Women’s Health Practice serves the uninsured, under-insured, Medicare, and Medicaid Managed Care population in New York City’s five boroughs, Manhattan, Bronx, Brooklyn, Queens, and Long Island. The practice is a mandated Article 28 space. In New York State, Article 28 is the section of state law that ensures that public health facilities are operating according to government and state guidelines (New York State Department of Health). The practice is located at 505 East 70th Street, New York, NY, in Manhattan’s affluent Upper East Side. The location of the practice poses unique challenges; it is located in a wealthy neighborhood but serves low-income families. The practice is considered a community clinic but does not serve the community the lives in the nearby zip codes, but rather people across the five boroughs that travel up to 2 hours to receive care; access is immediately a challenge. The practice sees approximately 1,900 patients a month post-Covid-19 under the supervision of OB/GYN Attending Physicians. The Women’s Health Practice provides general OB/GYN services and sub-specialty services that include reproductive endocrine, breast cancer, colposcopy, urogynecology, high-risk OB, IUD’s, contraceptive implants, oral contraceptives, and performs outpatient procedures like hysteroscopy and leep. There are 6 FTE Patient Registrars and 1 PTE Patient Registrar, 5 FTE Medical-Surgical Technicians, 5 FTE RN’s, 4 Nurse Practitioners, and 25 resident doctors that rotate throughout their four-year program. Currently, the HT5 Women’s Health Practice does not offer termination services. In 2017, there were 54,394 abortions reported in New York City. Chemical abortions accounted for approximately 24% of the total, an increase of 300% since 2001. African-American women made up the largest racial group with 38% of the abortions reported in the city, 14% were non-Hispanic white women, and 27% were Hispanic women (Longbons, 2019). The Women’s Health Practice patient population is 42% African-American women, 36% Hispanic, 12% white women, and 10% other. The demographic analysis alone, indicates a need to implement these services in the clinic to provide a full complement of services and ensure the safety and quality of care patients receive. The HT5 Women’s Health clinic can expand termination services through the oral administration of mifepristone and misoprostol and through MVA which is a manual vacuum aspiration performed in an outpatient setting. Women must be provided the opportunity to decide if and when to have children and access to safe and timely services. Lack of termination services at the HT5 Women’s Health Practice means that approximately 525 women annually are referred to an outside facility to receive services and return for their follow-up care; this is neither a best practice nor cost-effective. Both patients and resident physicians have expressed dissatisfaction with the lack of services, creating resident dissatisfaction regarding educational requirements that implicate the medical school and posing quality and continuity of care issues for patients; this will be explored further as the feasibility study develops. References: Guttmacher Institute. (2021, January). State Facts About Abortion: New York . Retrieved from : Leff, B., Burton, L., Mader, S., Naughton, B., Burl, J., Inouye, S., . . . Burton, J. (2005). Hospital at Home: Feasibility and Outcomes of a Program to Provide Hospital-Level Care at Home for Acutely III Older Patients. Annals of Internal Medicine, 798-808. Longbons, T. (2019, November 1). Abortion Reporting: New York City 2017. Retrieved from : New York State Department of Health. (.). NEW YORK STATE MEDICAID PROGRAM POLICY GUIDELINES MANUAL FOR ARTICLE 28 CERTIFIES CLINIC. Retrieved from State Funding of Abortion Under Medicaid. (2021, April 1). Retrieved from Guttmacher Institute: Evaluating Feasibility The concept of a feasibility study is central to viability, the “worth to the effort” ratio, and return on investment (ROI). What needs to be taken into consideration to create a feasibility study (., human resources, community needs, and technological advances, federal and state regulatory issues)? Within this section, you will research and design an economical health care service that is responsive to a given market. This research stems from understanding your target population and present need in health services. Furthermore, as you have seen from the Daniels and Dickson (1990) article, you must appraise your human resources, capital investment, and how your effort will yield a return on investment from a facilities perspective as well as the tangible greater good of providing healthcare to a community. Strategic Effect Analyze the role of public policy with regard to your project. What policies and processes should be in place to create an effective program? How will you measure the effectiveness of your program and your provision of health care services? Develop a microeconomic model that is responsive to the specific health care service demands of your target population. For example, the current trend of the medical home model, which allows for the coordination of care, allows for better communication among service providers as well as convenience for patients. Is the population a market priority? How does your program serve a need for your target population? Market Analysis Within this section you will identify the population demographics, who your competitors are, and whether or not a real need for the services you are proposing exists in the community. As you examine the demographic and population needs using Census data and other reliable sources, you must also consider what competitors, if any, exist in the present climate. This requires an evaluation of the present socioeconomic and cultural trends influencing how people make decisions in health care. In addition, in this analysis you will need to compare and contrast economic challenges and incentives among health care’s organization models. This comparison requires an understanding of past challenges and incentives that other organizations have implemented. Financial Analysis This section includes the revenue, expenses, and net income. Compare and contrast economic challenges and incentives by finding and describing multiple sources of public and private funding (., grants, donations, awards, special projects) for this project. Include a reference list for your funding sources that is formatted in APA as outlined in the Writing Center. Next, identify the funding constraints for each source. Include limitations of monies awarded, timing issues, fitting the needs of the funding sources, difficulties of connecting with private funders, etc. Finally, specify the internal ramifications of moving forward using SWOT analysis. What are the fixed and variable costs associated with your project? What are the annual maintenance and operation costs? Elaborate on how you arrived at your sensitivity analysis conclusions. Operations Performance This section examines the incremental effect of how your proposed service will impact all aspects of health services. This portion of the study explores how the statistical data you have researched affects the proposed service in terms of efficiency and value. This can be difficult to measure initially. However, through incremental and ongoing evaluation of operations, you can begin to see what constitutes the best performance in this instance and how it serves the target population. In this section, you will further illustrate the incentives and challenges faced by a health organization and communicate the relevance of economics within the . health care system as it pertains to your proposed services. Inpatient If your proposed study has an inpatient component, this section will analyze on volume of patients, types of payers, and how utilization rates impact your proposed study. In addition, you will further explain how your new inpatient service will add value for patients and improve the financial viability of the institution. This section will require you to use both qualitative and quantitative data to justify the plan. Hospitals operate in terms of how many beds are occupied relative to how many are empty. Most CEOs want to see that a unit is running at near full capacity and that volume is increasing year to year. Analyze how your proposal will meet these demands by explaining the data you have collected and predicting potential financial outcomes. Finally, evaluate and explain how value-based care will impact your ability to maintain margins within this newly proposed service. Outpatient If your proposed study has an outpatient component, examine how admissions, revenue, and workflow of staff will improve the efficiency of your proposed service. Analyze how your outpatient service will add value for patients and improve the financial viability of the institution. Justify your plan with appropriate data. As stated in the inpatient section, the content here applies much the same way. However, the caveat for outpatient services lies in the ambulatory setting. This aspect should be most interesting under conditions created by the Affordable Care Act. The new paradigm shift will be toward more preventative, primary, and outpatient care settings to reduce the numbers of patients being admitted to hospitals. Please explain how your proposal takes these conditions into consideration. In this section, you will further compare and contrast economic challenges and incentives among health care’s organization models in an outpatient setting. You will also further augment your design in an economic framework that is responsive to your market. Outlook This section examines future implications of your proposed services and how they will impact the future health outcomes of the community and financial health of the services being provided. Analyze economic theories that are germane to the provision of your proposed health services. What adjustments might you need to make in terms of what the “unintended consequences” may be? For example, Baylor Hospital in Houston proposed and spent 250 million to create a brand new hospital that currently stands empty because it was built during the . economic downturn, the loan was no longer able to finance the construction, and the initial examination of its necessity did not play out as expected. Provide conclusions and implications of how your feasibility study fits within the larger context of the system of services currently being provided. How do they work with one another within the larger health care system? Finally, evaluate how your study will respond to market and design models that impact the community based on current regulatory and market needs.
